Individual provider Active NPI

Donna Lanza, PT

  • Physical Therapist
  • Miller Place, NY
National Provider Identifier
1629056833
Registry record updated Sep 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
14510 Issued in NY
Practice address
691 Route 25a
BLDG 15
Miller Place, NY 11764-2643
Phone
(631) 332-1779
Fax
(631) 982-5650
NPI assigned
Jan 6, 2006
Last updated
Sep 23, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 14510 NY Primary

Addresses

Primary practice location

691 Route 25a
BLDG 15
Miller Place, NY 11764-2643

Mailing address

691 Route 25a
BLDG 15
Miller Place, NY 11764-2643
Phone (631) 332-1779

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14510NYMDPhysical Therapist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285200000000",
    "number": "1629056833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "691 ROUTE 25A",
            "address_2": "BLDG 15",
            "city": "MILLER PLACE",
            "state": "NY",
            "postal_code": "117642643",
            "telephone_number": "631-332-1779",
            "fax_number": "631-982-5650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "691 ROUTE 25A",
            "address_2": "BLDG 15",
            "city": "MILLER PLACE",
            "state": "NY",
            "postal_code": "117642643",
            "telephone_number": "631-332-1779",
            "fax_number": "631-982-5650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANZA",
        "first_name": "DONNA",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-06",
        "last_updated": "2010-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "14510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miller Place, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.